WHERE NEEDS AND DEMANDS DIVERGE - HEALTH PROMOTION IN PRIMARY-CARE

This study reviews Forth Valley Health Board's 'Be Better Hearted' cor onary heart disease health promotion programme by analysis of data rou tinely collected between 1988 and 1993. Associations between socioecon omic deprivation, prevalence of risk factors, and attendance at health promotion clinics are of particular interest in relation to future he alth promotion strategy. Method: A study was made of computerised reco rds of 20,053 baseline risk factor assessments in the primary care set ting and 1,058 follow-up attendances. A method of classification by so cioeconomic status was applied. Results: Baseline data provided a prof ile of new attenders over time with regard to age, gender, risk factor s and socioeconomic status but lack of follow-up information prevented evaluation of the outcome of the programme. There was a statistically significant association between prevalence of risk factors (such as s moking, obesity and lack of exercise) and deprivation. In the most aff luent areas 19.0% of the target population participated in the program me; in deprived areas this fell to 10.7%. There was thus a failure to involve those most in need of health promotion. Conclusion: If equity in provision of health promotion is to be achieved, measures must be t aken locally and nationally to reach deprived sections of the populati on. In this type of health promotion programme, baseline and follow-up information should be entered on computer at the clinical locus to en able monitoring of outcome. These conclusions are particularly relevan t to the national arrangements for health promotion in primary care wh ich were introduced in July 1993.